Stuff from the Review Flashcards
In what leads do you see atrial flutter best?
II, III, and AVF
What are the criteria on ECG for LBBB?
broad, double peaked R in I, AVL, sometimes V5-V6
Dominant S in V1
What tx is absolutely contraindicated in NSTE-ACS?
thrombolytics
In what cardiac condition are GP IIB/IIIA significantly helpful?
in high risk NSTE-ACS pts
What anticoagulants are preferred when treating ACS?
IV heparin first
enoxaparin used 2nd most often
What EKG abnormality other than ST elevation indicates a recent STEMI?
new LBBB
In what type of MI is sinus bradycardia common?
inferior MI
How, in general, do you tx SVT including A fib?
use rate controlling agents like metoprolol or CCBs ASAP
shock if unstable
amiodarone if that doesn’t work
In what type of MIs does a complete AV block occur?
more common in inferior MI
worse prognosis if it occurs in anterior MI
When would a papillary m rupture occur after MI?
How to tx?
3-7 days afer
need to do emergent echo and intra-aortic balloon pump
Sx is definitive tx
How do you treat acute LV failure w/ pulmonary edema?
O2
morphine
diuretics
vasodilators
What defines cardiogenic shock?
systolic BP < 90 and signs of decreased perfusion
no response to fluids
How do you treat cardiogenic shock?
urgent cath lab and echo
diuretics in less sick
ionotropic support (NE, dobutamine, etc) in more sick
In septic shock, what should be your goal for MAP?
keep above 65
What is PCWP and what does it represent?
pulmonary capillary wedge pressure
represents L atrial pressure
What is CVP and what does it represent?
central venous pressure (often measured as JVP)
represents R atrial Pressure
What are the CO, CI, SVR, CVP, and PCWP in cardiogenic shock?
decreased CO and CI
Increased: SVR, CVP, PCWP
If you have HAGMA secondary to diabetic ketoacidosis, what is the metabolic alkalosis due to?
volume depletion
contraction alkalosis
What are the modified wells criteria for PE risk?
> 4.0 –> PE likely
4.0 or less –> PE unlikely
(then do the diagnostic algorithm)
How do you tx an acute PE?
IV fluids
thrombolytic therapy w/ alteplase if hemodynamically unstable
initiation of heparin drip
long term start rivaroxaban
How would you tx NAGMA due to diarrhea?
IV fluids
potassium supplementation
avoid anti-diarrheal meds until stool pathogen panel back
What is the risk in using anti-diarrheal meds in C diff?
can lead to toxic megacolon
What type of acidosis can be caused by toluene toxicity?
How would you tx?
type 1 RTA
Tx: potassium supplementation, sodium bicarb or potassium citrate admin, avoid toluene
Obese patients with depression must be screened for what?
obstructive sleep apnea
